Purpura
Blood spots; Skin hemorrhagesPurpura is purple-colored spots and patches that occur on the skin, and in mucus membranes, including the lining of the mouth.
Considerations
Purpura occurs when small blood vessels leak blood under the skin.
Purpura measure between 4 and 10 mm (millimeters) in diameter. When purpura spots are less than 4 mm in diameter, they are called petechiae. Purpura spots larger than 1 cm (centimeter) are called ecchymoses.
Petechiae
Bleeding into the skin can occur from broken blood vessels that form tiny red dots (called petechiae). Blood also can collect under the tissue in la...
Platelets help the blood clot. A person with purpura may have a normal platelet count (non-thrombocytopenic purpuras) or a low platelet counts (thrombocytopenic purpuras).
Thrombocytopenic
Thrombocytopenia means there is an abnormally low amount of platelets. Platelets are parts of the blood that help blood to clot. This condition is ...
Causes
Non-thrombocytopenic purpuras may be due to:
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Amyloidosis (disorder in which abnormal proteins build up in tissues and organs)
Amyloidosis
Primary amyloidosis is a rare disorder in which abnormal proteins build up in tissues and organs. Clumps of the abnormal proteins are called amyloid...
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Congenital cytomegalovirus (condition in which an infant is infected with a virus called cytomegalovirus before birth)
Congenital cytomegalovirus
Congenital cytomegalovirus is a condition that can occur when an infant is infected with a virus called cytomegalovirus (CMV) before birth. Congenit...
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Rubella
Rubella, also known as the German measles, is an infection in which there is a rash on the skin. Congenital rubella is when a pregnant woman with rub...
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- Fragile blood vessels seen in older people (senile purpura)
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Hemangioma (abnormal buildup of blood vessels in the skin or internal organs)
Hemangioma
A hemangioma is an abnormal buildup of blood vessels in the skin or internal organs.
ImageRead Article Now Book Mark Article - Inflammation of the blood vessels (vasculitis), such as Henoch-Schönlein purpura, which causes a raised type of purpura
Henoch-Schönlein purpura
IgA vasculitis is a disease that involves purple spots on the skin, joint pain, gastrointestinal problems, and glomerulonephritis (a type of kidney d...
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Scurvy (vitamin C deficiency)
Scurvy
Scurvy is a disease that occurs when you have a severe lack of vitamin C (ascorbic acid) in your diet. Scurvy causes general weakness, anemia, gum d...
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- Certain infections
- Injury
Thrombocytopenic purpura may be due to:
- Drugs that reduce the platelet count
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Idiopathic thrombocytopenic purpura (ITP) -- a bleeding disorder
Idiopathic thrombocytopenic purpura
Immune thrombocytopenic purpura (ITP) is a bleeding disorder in which the immune system destroys platelets, which are necessary for normal blood clot...
ImageRead Article Now Book Mark Article - Immune neonatal thrombocytopenia (can occur in infants whose mothers have ITP)
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Meningococcemia (bloodstream infection)
Meningococcemia
Meningococcemia is an acute and potentially life-threatening infection of the bloodstream.
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When to Contact a Medical Professional
Call your health care provider for an appointment if you have signs of purpura.
What to Expect at Your Office Visit
The provider will examine your skin and ask about your medical history and symptoms, including:
- Is this the first time you have had such spots?
- When did they develop?
- What color are they?
- Do they look like bruises?
- What medicines do you take?
- What other medical problems have you had?
- Does anyone in your family have similar spots?
- What other symptoms do you have?
A skin biopsy may be done. Blood and urine tests may be ordered to determine the cause of the purpura.
Skin biopsy
A skin lesion biopsy is when a small amount of skin is removed so it can be examined under a microscope. The skin is tested to look for skin conditi...
References
Dinulos JGH. Principles of diagnosis and anatomy. In: Dinulos JGH, ed. Habif's Clinical Dermatology. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 1.
Kitchens CS. Purpura and other hematovascular disorders. In: Kitchens CS, Kessler CM, Konkle BA, Streiff MB, Garcia DA, eds. Consultative Hemostasis and Thrombosis. 4th ed. Philadelphia, PA: Elsevier; 2019:chap 10.
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Henoch-Schonlein purpura on the lower legs - illustration
Henoch-Schonlein Purpura. This disorder usually presents with red to purple bumps on the legs, often accompanied by aching in the joints and fever. This condition follows an infection and usually resolves without treatment. Skin lesions most commonly occur below the knee but may also be seen on the thigh, buttocks, and rarely on the arms.
Henoch-Schonlein purpura on the lower legs
illustration
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Henoch-Schonlein purpura on an infant's foot - illustration
Henoch-Schonlein purpura is more commonly seen in children than adults and often occurs after an upper respiratory infection. It causes skin rashes that bleed into the skin (petechiae and purpura). Bleeding may also occur from the gastrointestinal tract and kidneys.
Henoch-Schonlein purpura on an infant's foot
illustration
-
Henoch-Schonlein purpura on an infant's legs - illustration
Henoch-Schonlein purpura is more commonly seen in children than adults and often occurs after an upper respiratory infection. It causes skin rashes that bleed into the skin (petechiae and purpura). Bleeding may also occur from the gastrointestinal tract and kidneys.
Henoch-Schonlein purpura on an infant's legs
illustration
-
Henoch-Schonlein purpura on an infant's legs - illustration
Henoch-Schonlein purpura is more commonly seen in children than adults and often occurs after an upper respiratory infection. It causes skin rashes that bleed into the skin (petechiae and purpura). Bleeding may also occur from the gastrointestinal tract and kidneys.
Henoch-Schonlein purpura on an infant's legs
illustration
-
Henoch-Schonlein purpura on the legs - illustration
Henoch-Schonlein purpura is more commonly seen in children than adults and often occurs after an upper respiratory infection. It causes skin rashes that bleed into the skin (petechiae and purpura). Bleeding may also occur from the gastrointestinal tract and kidneys.
Henoch-Schonlein purpura on the legs
illustration
-
Meningococcemia on the calves - illustration
Meningococcemia is a life-threatening infection that occurs when the meningococcus, Neisseria meningitidis, invades the blood stream. Bleeding into the skin (petechiae and purpura) may occur. The tissue in areas may die (become necrotic or gangrenous). If the person survives, the areas heal with scarring.
Meningococcemia on the calves
illustration
-
Meningococcemia on the leg - illustration
Meningococcemia is a life-threatening infection that occurs when the meningococcus, Neisseria meningitidis, invades the blood stream. There is usually bleeding into the skin (petechiae and purpura), and the tissue in these areas may die (become necrotic or gangrenous). If the patient survives, the areas heal with scarring. This picture demonstrates more hemorrhage and little tissue death.
Meningococcemia on the leg
illustration
-
Rocky mountain spotted fever on the foot - illustration
Rocky Mountain spotted fever is caused by the organism Rickettsia rickettsii and is transmitted by a tick bite. It is a serious infection that produces a classical rash in about 90% of infected individuals. This is the typical appearance of the rash. There are many symptoms that affect the entire body (systemic).
Rocky mountain spotted fever on the foot
illustration
-
Meningococcemia associated purpura - illustration
Meningococcemia is a life-threatening infection that occurs when the bacteria, Neisseria meningitidis, invades the blood stream. Bleeding into the skin (petechiae and purpura) typically occurs and the tissue may die (become necrotic or gangrenous). If the patient survives, the areas heal with scarring.
Meningococcemia associated purpura
illustration
-
Henoch-Schonlein purpura on the lower legs - illustration
Henoch-Schonlein Purpura. This disorder usually presents with red to purple bumps on the legs, often accompanied by aching in the joints and fever. This condition follows an infection and usually resolves without treatment. Skin lesions most commonly occur below the knee but may also be seen on the thigh, buttocks, and rarely on the arms.
Henoch-Schonlein purpura on the lower legs
illustration
-
Henoch-Schonlein purpura on an infant's foot - illustration
Henoch-Schonlein purpura is more commonly seen in children than adults and often occurs after an upper respiratory infection. It causes skin rashes that bleed into the skin (petechiae and purpura). Bleeding may also occur from the gastrointestinal tract and kidneys.
Henoch-Schonlein purpura on an infant's foot
illustration
-
Henoch-Schonlein purpura on an infant's legs - illustration
Henoch-Schonlein purpura is more commonly seen in children than adults and often occurs after an upper respiratory infection. It causes skin rashes that bleed into the skin (petechiae and purpura). Bleeding may also occur from the gastrointestinal tract and kidneys.
Henoch-Schonlein purpura on an infant's legs
illustration
-
Henoch-Schonlein purpura on an infant's legs - illustration
Henoch-Schonlein purpura is more commonly seen in children than adults and often occurs after an upper respiratory infection. It causes skin rashes that bleed into the skin (petechiae and purpura). Bleeding may also occur from the gastrointestinal tract and kidneys.
Henoch-Schonlein purpura on an infant's legs
illustration
-
Henoch-Schonlein purpura on the legs - illustration
Henoch-Schonlein purpura is more commonly seen in children than adults and often occurs after an upper respiratory infection. It causes skin rashes that bleed into the skin (petechiae and purpura). Bleeding may also occur from the gastrointestinal tract and kidneys.
Henoch-Schonlein purpura on the legs
illustration
-
Meningococcemia on the calves - illustration
Meningococcemia is a life-threatening infection that occurs when the meningococcus, Neisseria meningitidis, invades the blood stream. Bleeding into the skin (petechiae and purpura) may occur. The tissue in areas may die (become necrotic or gangrenous). If the person survives, the areas heal with scarring.
Meningococcemia on the calves
illustration
-
Meningococcemia on the leg - illustration
Meningococcemia is a life-threatening infection that occurs when the meningococcus, Neisseria meningitidis, invades the blood stream. There is usually bleeding into the skin (petechiae and purpura), and the tissue in these areas may die (become necrotic or gangrenous). If the patient survives, the areas heal with scarring. This picture demonstrates more hemorrhage and little tissue death.
Meningococcemia on the leg
illustration
-
Rocky mountain spotted fever on the foot - illustration
Rocky Mountain spotted fever is caused by the organism Rickettsia rickettsii and is transmitted by a tick bite. It is a serious infection that produces a classical rash in about 90% of infected individuals. This is the typical appearance of the rash. There are many symptoms that affect the entire body (systemic).
Rocky mountain spotted fever on the foot
illustration
-
Meningococcemia associated purpura - illustration
Meningococcemia is a life-threatening infection that occurs when the bacteria, Neisseria meningitidis, invades the blood stream. Bleeding into the skin (petechiae and purpura) typically occurs and the tissue may die (become necrotic or gangrenous). If the patient survives, the areas heal with scarring.
Meningococcemia associated purpura
illustration
Review Date: 6/7/2023
Reviewed By: Elika Hoss, MD, Assistant Professor of Dermatology, Mayo Clinic, Scottsdale, AZ. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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